Colorectal cancer (CRC) is one of the most preventable forms of cancer, yet it remains the second-leading cause of cancer deaths in the U.S. One of the main reasons for this is that one-third of eligible patients — 23 million Americans — do not stay up to date with colorectal cancer screenings.
Such was the case with the late Congressman Donald M. Payne, who died from colorectal cancer that was detected too late for effective treatment. The tragedy of his story is by no means an outlier in the U.S. Approximately 50,000 people die each year from CRC, and 60 percent of them are not screened regularly, leading to late-stage diagnoses. As a result, nearly $5 billion of the $15 billion spent annually within our healthcare system for CRC-related care is spent on end-of-life measures for treatment of late-stage colorectal cancer.
{mosads}The Cancer Moonshot group recently confirmed this reality. In its Blue Ribbon Panel report, released on Sept. 7, it found that “evidence-based strategies” to prevent cancers such as CRC “are not currently accessible to all individuals or are being adopted by too few people, leaving millions of Americans at high risk for preventable, yet deadly cancers.” The report also cited the pressing need to better understand why proven cancer prevention strategies are not being more widely used, finding that increasing the use of these strategies could reduce deaths from CRC by up to 70 percent.
Minorities and those from rural communities would benefit from expanded access to evidence-based strategies to prevent colorectal cancer, as they are disproportionately impacted by the disease. African-Americans are 18 to 28 percent less likely to participate in CRC screening, have a rate of CRC that is 25 to 30 percent higher than whites, and are 38 to 43 percent more likely to die of CRC. Those who live in rural America, and do not live within 30 minutes of their healthcare provider, are 67 percent less likely to get screened, resulting in CRC being diagnosed in later stages of the disease.
The key to surviving CRC is ensuring access and participation in screening. However, despite significant awareness and patient navigation efforts, screening rates have plateaued for the last 10 years due to a number of historic barriers that haven’t been overcome. Fortunately, there are new tools that address these barriers and new data that show how we can finally extend screenings to underserved populations.
In April, the U.S. Food and Drug Administration (FDA) approved a non-invasive test that detects the presence of a DNA marker that may be present in the blood of patients with CRC. However, payment policy is not yet in sync with testing technology. As such, the Centers for Medicare and Medicaid Services (CMS) reimbursement for this FDA-approved test is not formally authorized, despite the fact that the FDA has required a rigorous review process to demonstrate performance. Should the CMS payment be authorized and full adoption occur, it has been estimated that 10,000 lives per year could be saved with a potential savings of billions of dollars.
For these reasons, we have introduced a bill that would provide Medicare coverage for all FDA-approved blood-based screening tests with available screening methods and authorize equivalent CMS reimbursement. Recently published data for this blood test decisively showed that 99.5 percent of people who were offered but twice refused prior screening did, in fact, opt for a blood test for CRC screening. Only by formalizing CMS payment and eliminating this important barrier will we truly be able reach those who are not screened today.
On Sept. 29, we are convening leading experts within the colorectal cancer and gastrointestinal communities. The purpose of this discussion is to share new data and efforts underway that demonstrate how innovative approaches can significantly reach underserved populations. We will also discuss the Donald Payne Sr. Colorectal Cancer Detection Act of 2016, which will ensure that these new screening tools will be widely available, particularly to historically unreachable populations.
We are asking members and staff on both sides of the aisle to join us in this event and to support this legislation. By doing so, we can take a critically important step to save lives and make health care more affordable and accessible.
Payne Jr. has represented New Jersey’s 10th Congressional District since 2012. He sits on the Homeland Security and the Small Business committees, and is co-chairman of the Congressional Men’s Health Caucus. Dent has represented Pennsylvania’s 15th Congressional District since 2005. He is chairman of the Ethics Committee and also sits on the Appropriations Committee.